CAJ | 학술논문

目的：探讨有创-无创机械通气序贯脱机治疗严重呼吸衰竭的临床疗效。方法：35例严重呼吸衰竭患者采用以呼吸泵衰竭改善为切换点的有创-无创机械通气序贯脱机治疗，设为序贯治疗组，35例严重呼吸衰竭患者采用常规有创机械通气脱机治疗，设为对照组。动态观察并比较两组患者总机械通气时间、有创机械通气时间、重新插管率、呼吸机相关肺炎（ VAP ）发生率、住院时间。结果：有创-无创机械通气序贯脱机治疗重度呼吸衰竭疗效显著。两组机械通气前APACHEⅡ评分比较差异无显著性（ P＞0．05）。序贯组总机械通气时间、有创机械通气时间、住院时间及呼吸机相关性肺炎发生率较对照组明显降低，差异有显著性（ P＜0．05）。结论：以呼吸泵衰竭改善为切换点的有创-无创机械通气序贯治疗可显著降低患者总机械通气时间、有创机械通气和住院时间，减少呼吸机相关性肺炎的发生。
목적：탐토유창-무창궤계통기서관탈궤치료엄중호흡쇠갈적림상료효。방법：35례엄중호흡쇠갈환자채용이호흡빙쇠갈개선위절환점적유창-무창궤계통기서관탈궤치료，설위서관치료조，35례엄중호흡쇠갈환자채용상규유창궤계통기탈궤치료，설위대조조。동태관찰병비교량조환자총궤계통기시간、유창궤계통기시간、중신삽관솔、호흡궤상관폐염（ VAP ）발생솔、주원시간。결과：유창-무창궤계통기서관탈궤치료중도호흡쇠갈료효현저。량조궤계통기전APACHEⅡ평분비교차이무현저성（ P＞0．05）。서관조총궤계통기시간、유창궤계통기시간、주원시간급호흡궤상관성폐염발생솔교대조조명현강저，차이유현저성（ P＜0．05）。결론：이호흡빙쇠갈개선위절환점적유창-무창궤계통기서관치료가현저강저환자총궤계통기시간、유창궤계통기화주원시간，감소호흡궤상관성폐염적발생。
Objective:To explore the clinical therapeutic effect and feasibility of sequential invasive to noninvasive mechanical ventilation in severe respiratory failure .Method: Treatment group was 35 patients with severe respiratory failure underwent sequential invasive and noninvasive mechanical ventilation at the switch-point of respiratory pump failure improved ,control group was 35 patients with underwent conventional treatment ,and analysed and compared the total mechanical ventilation time , pressure invasive mechanical ventilation time , incidence rate of repeated tracheal intubation , the incidence rate of ventilator associated pneumonia ( VAP ) and total length of stay .Result: Sequential invasive and noninvasive mechanical ventila-tion in severe respiratory failure had significant therapeutic effect .There was no significant difference of A-PACHEⅡscore between the two groups .The total mechanical ventilation time , pressure invasive mechanical ventilation time , total length of stay and the incidence rate of VAP in treatment group were lower than con-trol group(P<0.05).Conclusion:Sequential invasive and noninvasive mechanical ventilation at the switch-point of respiratory pump failure improved can reduce total mechanical ventilation time , the pressure invasive mechanical ventilation time and total length of stay .It can reduce the incidence rate of VAP .